Abstract
Background: The anterior talofibular ligament (ATFL) is the ligament most commonly injured during ankle sprains. Objective: The purpose of this investigation was to assess the sensitivity of Magnetic Resonance (MR) imaging for ATFL with open surgery, Brostrom-Gould surgical interventional considered the gold standard. Methods: A retrospective chart review using Operating Room (OR) and MR reports from April 2008-November 2009 led to a review of 137 charts, with 15 cases meeting the inclusion criteria. Results: The sensitivity for ATFL tears irrespective of extent of the tear was 93%. For full thickness ATFL tears, 10 were found to be positive on MR but 13 on OR with a sensitivity of 77%. Of the three missed cases, 2 were described as sprain injuries and the other normal using MRI. Conclusion: The recommendations for MR assessment of ankle injury include use of dedicated sequences and understanding the “pseudoband” concept. The two full thickness and two partial thickness tears on OR described as sprain injuries on MRI had a band of inflammatory granulation tissue. This tissue accounted for the appearance of the thick continuous band at MRI, the pseudoband. This study reaffirms the usefulness of MR in determining ATFL tears, aiding surgical decision making.
Highlights
Ankle sprains are the most common injuries accounting for 20% of sport injuries in the United States [1]
With Magnetic Resonance (MR) imaging being a key modality in the diagnosis of ligament tears and sprains, it is important to understand the ability of MR imaging to detect anterior talofibular ligament (ATFL) injury and direct surgical management
The cases that were described as sprain injuries on MR but were identified as full thickness or high grade partial thickness tears at Operating Room (OR) had one common feature
Summary
Ankle sprains are the most common injuries accounting for 20% of sport injuries in the United States [1]. With MR imaging being a key modality in the diagnosis of ligament tears and sprains, it is important to understand the ability of MR imaging to detect ATFL injury and direct surgical management. The purpose of this investigation was to assess the sensitivity of MR imaging for ATFL at two hospitals in Hamilton, Ontario, Canada. The two full thickness and two partial thickness tears on OR described as sprain injuries on MRI had a band of inflammatory granulation tissue. This tissue accounted for the appearance of the thick continuous band at MRI, the pseudoband. This study reaffirms the usefulness of MR in determining ATFL tears, aiding surgical decision making
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